Individual provider Active NPI

Kimberly Mangabadi, ARNP

  • Nurse Practitioner
  • Miami, FL
National Provider Identifier
1790181527
Registry record updated Sep 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9289640 Issued in FL
Practice address
15049 SW 9TH Way
Miami, FL 33194-2475
Phone
(305) 335-3575
NPI assigned
Nov 5, 2014
Last updated
Sep 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9289640 FL Primary

Addresses

Primary practice location

15049 SW 9TH Way
Miami, FL 33194-2475

Mailing address

15049 SW 9TH Way
Miami, FL 33194-2475
Phone (305) 335-3575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9289640FLMDNurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663372800000",
    "number": "1790181527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15049 SW 9TH WAY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331942475",
            "telephone_number": "305-335-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15049 SW 9TH WAY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331942475",
            "telephone_number": "305-335-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGABADI",
        "first_name": "KIMBERLY",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-05",
        "last_updated": "2022-09-17",
        "certification_date": "2022-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9289640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.